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Hi to all…
I am Dr. Yousaf Jamal
from Pakistan. I passed my FRCS3 Glasgow in Delhi in Sep 2014 in first
chance Alhamdulillah. I want to share my experience here so that in
future it may help other candidates.
I will like to thank
Almighty Allah who rewarded me. I want to thank my supervisor and my
teachers who encouraged me to go for this exam. I also thank Prof.
Chua for his wonderful website, Prof. Muthu virtual university whose
weekly questions were guiding the path and FRCS Yahoo group where I
found related material and experience for the exam.
My experience regarding
study material….
1.
Must read
Chua website thoroughly especially the past candidates experiences,
Pathology slides and surgical instruments.
2.
Must
enroll yourself with Prof. Muthu virtual university (mvupgo.com) where
his weekly questions give you the exact idea of exam. It’s very
helpful.
3.
FRCS
yahoo group is also good source.
4.
Books
are… Kanski, Wong, Oxford handbook of Ophthalmology (last 100 pages),
medical emergencies from Oxford handbook of medicine, AAO (for General
medicine related to eye, cataract surgery in special situations,
Squint surgery complications and Tx, Anophthalmic socket and
Prosthesis) and Case reviews in ophthalmology (by Neil J. Freidman).
My advice to Pakistani
candidates is that attempt FRCS3 after your FCPS exam bcz you will
feel it easy. Also, India is good center for exam but only one problem
of VISA, you get Indian visa just 2-3 Days before exam, so be ready
for that. And try to go for exam with friend… it’s not necessary, I
was all alone.
The examiners are
really very nice and try to guide you. Mental blocks are natural and
they understand it.
Now I will share my
exam experience. I got visa just 3 days before exam but managed to
reach Delhi on time.
First day was clinical
examination.
STATION
1….Posterior segment:
I managed to see three
cases.
1st case was
young female with swollen disc. Examiner asked me the diagnosis; I
asked to examine the other eye which was ok. He showed me her OCT
which had CME but now resolved. I told it is posterior uveitis. He
asked me the causes. Later I thought she may be case of Intermediate
uveitis.
2nd case was
male with CRVO. I was asked about causes, difference between ischemic
& non-ischemic CRVO and investigations.
3rd case was
female with round 1.5-2 DD rounded lesion inferior to disc with
punched out pattern and hyperpigmented borders. I was asked about
diagnosis, I said I have two differentials of either choroidal
coloboma or toxoplasma scar. Examiner asked me about toxoplasmosis.
However it was choroidal coloboma.
STATION 2…
Neuroophthalmology and Ocular motility:
I managed to see three
cases.
1st case was
young female with left ptosis, down and out eye with dilated pupil.
Was case of surgical 3rd nerve palsy. I was asked about
causes, investigation and treatment.
2nd case was
to examine pupil. Patient had total APD and was case of old ACG. I was
asked to examine the disc and found pale cupped disc. Was asked about
causes of unilateral sudden visual loss.
3rd case was
again pupil examination of female. This time was RAPD and was asked
about causes.
STATION 3…Oculoplastics
and Lids:
Saw two cases.
1st case old
female with cicatricial ectropion. Was asked about causes of watery
eyes. What test you do for ectropion and demonstrate each one.
Treatment options.
2nd case was
complicated case of ptosis surgery following trauma. I was asked to do
the relevant measurements and examination and was asked about the
importance of each test. What is the principle of sling procedure?
STATION
4…Anterior segment:
Saw two cases.
1st case was
old female with posterior synechiae and cataracts. Asked about
evaluation and treatment. How to do cataract surgery in miosed pupils?
2nd case was
old female with penetrating keratoplasty and aphakic eye. Was asked
about possible sequence of events in this eye. Causes of graft
rejection, types of suturing techniques and their advantages.
It was a good day and I
was satisfied. There was one day gap for oral examinations. As I was
alone I couldn’t study well, that’s why partner is good.
Oral examination.
STATION 1…General
Medicine & Neurology:
1st
examiner asked me in neuroophthalmology.
Case scenario… 26
yrs.pt. with headache, B/L 6th Nerve palsy and normal
neuroimaging. Diagnosis was IIH. Was asked in detail about risk
factors, causes, investigation and treatment.
Causes of papilledema
and disc findings in acute papilledema.
Color picture showing
ciliary staphyloma. Was asked about diagnosis. I told necrotizing
scleritis but examiner not satisfied, later he told me its
scleromalacia perforans. Then asked me systemic associations. Some
discussion on Wagner’s granulomatosis.
Another scenario of of
old patient diagnosed of abdominal lymphoma presents with loss of
vision and you see whitish patches in fundus with hemorrhages and
vitreous haze. What is diagnosis. I told it can be PIOL or metastasis,
but examiner not satisfied. He said do you think this patient will be
immunocompromised; I said yes and told it may be viral (herpes, CMV,
AIDS). He said yes but what’s the diagnosis? I couldn’t answer… he
told me it’s ARN. But I didn’t understand bcz ARN occurs in
immunocompetent person.
2nd
examiner asked in general medicine.
Case scenario… you are
examining fundus of a patient and suddenly he becomes cold and clammy.
What’s your diagnosis? I couldn’t reach the diagnosis but I said these
are signs of shock. He helped me by saying in which metabolic
condition you examine fundus? I said Diabetes, and then he said now
what it can be. Here I got the clue that patient had an attack of
hypoglycemia, examiner was satisfied. He asked me treatment of
hypoglycemia, how you differentiate between hypo & hyperglycemia
clinically? Complications of hypoglycemia?
Another scenario…
patient after head surgery 10 days back present with chest pain,
what’s diagnosis? I said pulmonary embolism. He asked me other signs
and symptoms of PE. He asked me about type of chest pain in PE which I
couldn’t answer…its pleuritic. He asked me about other causes of chest
pain. Asked me about signs/symptoms and only examination findings in
pneumothorax. Then asked about treatment of pneumothorax. Again he
came to PE and said which one investigation you will like to do. I
said D-Dimers. Then he asked about other investigations in PE.
Treatment of PE. Name three diseases with chest pain with falling bp
and rising pulse.
STATION
2…Ophthalmic Medicine:
1st
examiner…
Showed me fundus
photograph of bergmiester papilla. Asked about cause of this?
Another picture of iris
atrophy and glaucomflecken… was asked in detail about ACG. Acute and
long term management.
Then was shown Humphrey
visual field. But bell rang.
2nd
examiner…
Asked about Aniridia in
detail. Genetics, ocular and systemic association. Complications and
treatment and follow-up.
Fundus picture of BRAO.
Was asked about investigation and treatment.
Another picture of PUK.
Just name it.
STATION
3…Ophthalmic surgery & Pathology:
1st
examiner…
Showed me picture of
swelling near medial canthus. Was CDC. Asked about treatment and
complications.
Another picture of
limbal dermoid. Asked about complications and treatment.
Another picture of PXF.
Asked about complications and management.
2nd
examiner…
Showed me picture of
shallow AC after Trab. Asked about causes and detailed discussion on
malignant glaucoma.
Management of traumatic
subluxated and luxated lens.
Scenario with picture
of ON glioma. Asked about the systemic association and other ocular
presentations in NF-1.
My experience is that
this exam is not very difficult but if you prepare with guidance. So
best of luck .
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